Steven Lamm, M.D., in his excellent book, The Hardness Factor, likes to say, “The heart and the penis are one“. Is he exagerrating? Not in the slightest and all of us males should consider that many of the leading risk factors for cardiovascular disease are also risk factors for erectile dysfunction and impotence, including hypertension (or high blood pressure), metabolic syndrome, LDL, being overweight, depression and so on.
The point is really obvious when you stop to think about it, because a lot of heart disease has to do with endothelial function – the endothelium is the delicate lining of your veins and arteries – and endothelial function is ground zero for erections. Having a healthy, youthful endothelium is critical for our sex lives and a plaque-filled, damaged endothelium is not going to help supply blood to the arteries of your penis.
In fact, for the majority of you that made it to this site, it took you decades of putting your body through physiological hell to get where you are at. Erectile dysfunction is generally heart-related and now you need to repair your endothelium, especially the ones in the groin area! This page and my page on How to Repair Your Erectile Dysfunction is where I show you how.
Remember that the arteries that supply your heart are larger than the ones that supply your penis and, therefore, which is why penile arteries and veins often show symptoms first. Erectile Dysfunction is usually a Shot Across Your Bow, a warning of impending heart disease, so you should definitely take it very seriously. Several studies have shown that, at least for diabetics and those in the early stages of heart disease, erectile dysfunction about doubles your risk of a heart attack. 
Furthermore, heart disease damages the delicate lining of your veins and arteries, which in turn whacks your best bedroom buddy: Nitric Oxide. Nitric Oxide is the stuff of erections. The way an erection works is both complex and simple at the same time: the lining of your blood vessels, called the endothelium, releases Nitric Oxide. Nitric Oxide in turn relaxes the veins and arteries allowing increased blood flow into the penis. This is the mechanism that Viagra, Cialis and Levitra use: they keep Nitric Oxide in your bloodstream longer.
So, generally, to improve your erectile dysfunction, you must get your endothelim back in shape and increase your Nitric Oxide output. Start now! What are you waiting for? You will be able to feel the improvements almost right away. Below are The Keys to Erectile Repair. It’s time for your sexual nightmare to end. It’s time to improve your erectile dysfunction and enjoy life again!
- The Kuna. Imagine a world with virtually no heart disease. I wonder if you can. Well, there are several cultures that come darn close and one is the Kuna. I highly recommend that you read about them here. Think of the irony: I write this from America where we have million dollar equipment and highly paid doctors on every street corner. Yet we are plagued with heart disease and erectile dysfunction. Yet around the globe there are cultures with almost no modern medicine where the people have almost no angina, heart attacks or hypertension!
- Avoid the Atkins (Low Carb). In my opinion it’s prudent to avoid any diet that is too high in saturated fat. Read my page on Why Saturated Fat Can Be Hard on Arteries and Erections for more information. Remember that decreasing saturated fat is, in general, associated with decreased LDL counts.  And remember that increasing saturated fat is associated with decreased nitric oxide and blood flow.
- The Low Fat (or Ornish Diet) versus the Atkins/Low Carb/Paleolithic Diet. The Low Fat (or Ornish) Diet will, in general, lead to greater blood flow and avoid much of the arterial damage of the Western Diet. One recent study showed it clearly beating out the Atkins (Low Carb) Diet in all major erectile categories. Read about How the Low Fat Diet Improves Erectile Strength...
- Sleep. Scientists have recently discovered something that should not be a big surprise: lack of sleep is tied to heart disease as well. What they actually discovered in a recent study is that the arteries of people getting low sleep levels (less than five hours) actually become calcified.  Calcified arteries are just what they sound like: hardened arteries. Further verifying this is the fact that those getting the most sleep, greater than 7 hours, had a low incidence of calcification. Columbia University researchers discovered that those burning the candle at both ends, i.e. getting less than five hours sleep, cause themselves almost immediate cardiovascular problems: elevated blood pressure and pulse rates. In other words, sleeping less than five hours immediately puts you into one of the highest risk categories for heart disease.  Lack of sleep also lowers your testosterone levels and leads to Metabolic Syndrome, both risk factors for Erectile Dysfunction. Now no one has done a study yet directly tieing erectile dysfunction and lack of sleep, but trust me that hardened arteries will be BAD for your sex life. You want nice, flexible, expandable arteries into your penis.
- Extra Virgin Olive Oil. Ironic that something called Extra Virgin can help you with your sex life, eh? Well, it’s true: the phenols in Olive Oil – and, yes, stick with Extra Virgin as it is loaded with many more of the critical phenols – boost your dear friend Nitric Oxide. As an added bonus, the monounsaturated fats also help boost testosterone. But is that really the end of the story? Read here about How Olive Oil Can Damage Your Sex Life.
- Saturated Fats. Several studies have shown that saturated fats hinder blood flow and endothelial function. The famous carrot cake study showed that blood flow decreased 32% after a saturated fat meal but that was no shock to researchers. And decreased blood flow is something none of us middle aged and beyond guys need if you know what I mean.  Decreased blood flow is the road to impotence. By the way, almost all saturated fats also raise cholesterol levels and remember that those in the lowest tier of cholesterol have almost no heart disease. One study from Europe, for example, found that fat from both cheese and butter raised cholesterol levels.  In fact, saturated fat raises cholesterol more than eating cholesterol does! (One exception seems to be stearic acid, which is found in abundance in chocolate. ) Anyway, for more information, please see my link on Why Saturated Fat Is Often Bad For Men According to the Research. In addition, saturated fats also appear to put one at greater risk for Alzheimers: see this link on Rebuilding Your Brain. CAUTION: Chicken and turkey, although lower in saturated fat, flood the body with inflammatory chemical messengers, so caution should be exercised here. For protein I recommend a daily reliance on Egg Whites. Fish for protein is excellent but only if consumed once or twice per week. See my link on the Healing Powers of Fish for more information. &
- HDL. One study found HDL a powerful stimulator of Nitric Oxide. The head of the study stated, “HDL is the most potent stimulator of nitric-oxide production that we have found in the past decade. What we’re realizing is that, not only is it a taxi, but that it hits the arterial walls, and it causes a dramatic response by the arterial walls to produce nitric oxide”.  Although I don’t know of any studies that show the higher the HDL, the more the improvement in erectile dysfunction and impotence, this is very likely to be the case. For easy ways to increase your NO production through HDL, just go here. CAUTION: Countless studies have shown the benefits of HDL to the cardiovascular system. However, one recent study found that HDL can actually be detrimental to diabetics by binding with one of the body’s protective chemicals called myrestic acid which in turn actually inhibits NO production.
- Milk Protein / Casein. Watch out for milk protein. Dairy has been implicated as being a strong risk factor for Prostate Cancer. And a recent animal study shows that casein, a.k.a. milk protein, actually lowered the Nitric Oxide levels of lab animals. I know of no studies that directly correlate dairy with erectile dysfunction, but you do not want to rely on anything that lowers your precious Nitric Oxide levels. 
- Pistachios. One recent study showed that just one serving of pistachios daily lowered LDL cholesterol (by 9%) and cholesterol in individuals with moderately bad LDL levels.  Of course, remember the best LDL and cholesterol lowering strategy is a Low Fat (or Ornish) Diet. Remember that LDL is a risk factor for erectile dysfunction and impotence.
- Decaf Coffee. Decaf coffee is made from a different bean than regular coffee and raised a certain type of fat that can in turn raise LDL (bad cholesterol). This will very likely damage your cardiovascular system long term. Again, LDL is a risk factor for impotence.
- QUESTIONABLE: Folic Acid, Vitamin B6, Vitamin B12. There are great reasons to take Folic Acid and the B Vitamins in moderation and that has to do with the Brain. However, those reasons do not appear to extend to the heart and the penis. At one time it was thought elevated homocysteine levels was an independent risk factor and predictor of heart disease. The above vitamins all lower homocysteine and so, the thinking was at one time, supplementing with combinations of these three would help with heart disease (which would help with erections long term as well). However, this has not proven to be the case: it appears that elevated homocysteine is more likely a symptom than a cause of heart disease and a recent metanalysis reverified just that.  CAUTION: You can definitely take too much folic acid/folate: it has implicated in GI cancers.
Well, there you have it. I have given you the most important points about how to greatly improve your erectile dysfunction and eliminate impotence. This is incredibly good news for most of us middle aged and beyond guys who assumed that we had hit the Ultimate Wall. And notice something else important: the research is showing you do not have to spend a fortune to heal your erectile dysfunction: it is almost all at the grocery store (and your gym)
7) Journal of the American College of Cardiology, 2006; 48(4): 715-720
11) J Biol Chem; Apr 14, 2000; 275(15):11278-83
14) Hypertension. 2006,Nutr Rev,Aug 2007,65(8 Pt 1):361-375
18) Ann Intern Med. 2001 Jun 19;134(12):1106-14
30) Brit J of Nutr,July 2003,90(1):13-20; Brit J of Nutr,2007, 97(1):67-76
34) Amer J of Clin Nutr, 1994, 60:1023S 1028S
37) JAMA, 2008, 300(24):2859-2866p>
38) Amer J of Clin Nutr, Sep 2008, 88(3):651-659
40) Cochrane Database Syst Rev 2009, 4:CD006612, “Homocysteine lowering interventions for preventing cardiovascular events”
43) J of Lipid Res, 1997, 38:459-468, “Reducing saturated fat intake is associated with increased levels of LDL receptors on mononuclear cells in healthy men and women” associated with increased levels of LDL receptors on mononuclear cells in healthy men and women”
44) Amer J of Clin Nutr, Nov 2004, 80(5):1102-1103, “Saturated fat prevents coronary artery disease? An American paradox”